Riding Liability Release

Riding Liability Release

JASON LEPORE/DOUBLE HELIX HORSEMANSHIP LLC 19406 Cherokee Rd, Bend, OR 97702
Rider's Name:*

First NameLast Name
Rider's Phone Number:*
Please enter a valid phone number.
Rider is a minor (under 18).Rider is NOT a minor.
Parent's Name:*

First NameLast Name
Parent's Phone Number:*
Please enter a valid phone number.
Emergency Contact Name:*

First NameLast Name
Emergency Contact Phone:*
Please enter a valid phone number.
Billing Email (where invoices should be sent):
example@example.com
HELMET:*

Rider WILL use a horseback riding helmet.Rider WILL NOT use a horseback riding helmet.
HORSEBACK RIDING HELMET: I understand that a helmet is an essential safety item provided free of charge and that I can possible lessen or prevent injury to myself by wearing a helmet. I also understand that HORSEBACK RIDING is a sport that carries some rise and that HORSEBACK RIDING without a helmet increases that risk. The STABLE has offered and provided at the RIDER’S request an equestrian helmet that meets SEI certification-ASTM F1163 standards for use when riding or near HORSES. The RIDER, and on behalf of their children and/or legal ward, heirs, administrators, personal representatives or assigns, releases and discharges the RELEASEES from all claims, demands, or causes of action, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of bodily injury or property damage that may be sustained, or property damage which may occur as a result of the use of the HORSEBACK RIDING helmet provided. The RIDER also understands that neither this STABLE, its employees, nor any RELEASEE can guarantee the suitability of any helmet provided.
I WILL WEAR A HORSEBACK RIDING HELMET. Initials (Please initial.)
NO HORSEBACK RIDING HELMET: The RIDER has been fully warned and advised by this STABLE that they should wear a helmet, while riding or near HORSES to reduce the severity of some of the RIDER’S potential head injuries and possibly prevent their death from happening from a fall or other occurrence. Bicycle and other type of helmets are not designed to protect the RIDER from head injury in the event of a fall from a HORSE or other HORSE related activity at this STABLE. The RIDER has chosen to ride without a HORSEBACK RIDING helmet and to assume the risk of injury. In addition to all other claims, the RIDER releases this STABLE from any legal responsibility for injury the RIDER sustains due to refusing to wear a HORSEBACK RIDING helmet. The RIDER acknowledges that this STABLE offered a horseback-riding helmet to them.
I WILL NOT WEAR A HORSEBACK RIDING HELMET. blanks (Please initial.)
Rider's Signature (parent or guardian must sign also if the rider is a minor):*

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Parent or Guardian Signature:*

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Date Signed:*

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